Gradual extrusion of implant: an unusual complication after intraocular lens implantation.

A 65-year-old woman had undergone cataract extraction with implantation of an intraocular lens (IOL) in the left eye 5 years previously. The eye remained irritated and she did not regain useful vision. She had pain and foreign body sensation in that eye for 3 months that became especially severe in the 3 days prior to presentation. On examination, the optic and one haptic of an IOL protruded through a small fistula in a leukomatous cornea. The tip of the other haptic was embedded in the fistula. The surgical scar was intact and there was a circular depression on the superior cornea identical in size and shape to the optic. There was no history of trauma or rheumatoid arthritis. The IOL, barring one haptic, may have extruded through the site of a perforated corneal ulcer and remained impacted on the corneal surface, allowing healing under it. This is an extremely unusual presentation of an extruded IOL.